Paper or not –an equivalence study of analog vs digital neuropsychological tests to combat postoperative neurocognitive decline

Background: One of the most common complicationsafter surgeryaffecting older adultsis postoperative neurocognitive decline, whichcausesdisturbances inmultiple cognitive domains such as memory,executive function, information processing,speed,and attention.The traditional way of assessing cognitive performance is through analog test batteries conducted with paper and pencil; however, modern digital tests have a higher degree of compliance and enable more standardized execution.
Method: Followinga randomized cross-over design, we recruited self-reported cognitively healthy older adults(n=50) to undergoanalog and digital tests within twoweeks.Moreover, we interviewed twenty of the fifty participants about their test experiences. Our primaryoutcomeswereto measureequivalencybetweenananalog neuropsychological testwithatest leader anda self-administereddigital neuropsychological testand investigatefeasibility, usability,and acceptabilityof the latter.
Results: Preliminary findings showthe mean scores of most ofthe neuropsychologicaltestswere not statistically different(p<0.001). Pearson correlation testshowed r=0.33-0.59between the relationship of the analog and digital tests. Most participants (56%) preferred taking the digital test, and nearly all participants (94%) reported that they would take the digital test if they would undergo a future surgery. Furthermore,theparticipants statedhighuser-friendlinessin the digital test.
Conclusions:We will apply these findingsin a clinical study with perioperative patientsto detect and support the patient’s cognitive recovery. Our findings are vital in developing adigital interventionto implement in the clinical setting, and potentially preventingpostoperative neurocognitive decline.